Can I Get Social Security Disability for Depression and Anxiety?
By Wally Mountz / April 2, 2017 / Applying for Social Security Disability & SSI Benefits / 104 Comments
You may be able to get SSDI for severe depression and anxiety, if you can prove your symptoms are truly disabling. We explain the steps you must take to have your case approved if you are qualified.
Winning a successful disability claim on the basis of depression or anxiety is difficult unless your symptoms are severe and you can prove they are debilitating enough to interfere with your work.
Documentation could include medical treatments and consultations from recognized mental health practitioners and facilities, a treatment history for your symptoms, and a work record which reflects a disrupted work schedule due to your medical condition. Below are several approaches to supporting your claim.
The Symptoms of Depression and Anxiety
Depression and anxiety are terrible afflictions that can completely turn your life on its head. There are treatments for these illnesses, however often they become long, drawn out intervention plans that may not be completely effective. Dealing with such medical problems can be overwhelming, and adding financial pressures because of lost time at work or medical costs just make the situation worse. Nonetheless, there could be help in the way of payments to you through the Social Security Disability and/or Supplemental Security Income programs, both administered by the Social Security Administration.
Depression is the most common not-imminently fatal medical condition leading to disability in America. The World Health Organization has identified depression as the number one cause of disability in the world with over 300 million sufferers.
Depression causes a person to feel a significant state of sadness, guilt, inadequacy, dejection, and despondency. Along with such feelings there maybe insomnia, restless sleep, excessive sleep, lack of energy, reduced or no sexual desire, and appetite loss or excessive eating.
Anxiety is another frequently seen emotional condition. Although different from depression it sometimes accompanies depression and has some similar symptoms including a sense of foreboding, and obsessive thoughts. Anxiety can range from low-grade chronic worry to strong feelings of fear to outright panic and is often accompanied by agitation. The symptoms can also include uncontrollable sweating, nausea, increased heart rate, or shaking, even chest pains that mimic a heart attack.
Causes of Depression or Anxiety
Although it is not clear, family genes or other biological reasons may cause or influence the emergence of depression. It is not uncommon to see these conditions shared by members of the same family. Depression may also be brought on by changes in one’s life such as divorce, death, or a job change, however, such periods of depression normally resolve themselves within a relatively short period of time. However, if such a severe mood lasts every day for two-weeks or longer, then depression may require treatment to be resolved. If your depression has been persisting, it is important to seek treatment early, both for treatment and to document its existence and severity should you have difficulty recovering and have to file a disability claim.
Anxiety may come on for no apparent reason or may also be familial. If left untreated, anxiety can worsen to the point that it interferes with the ability to concentrate and complete tasks needed for normal work activities. Some individuals’ anxiety reaches the point that they may refuse to leave their homs for fear of triggering an episode of panic.
Let’s take a closer look at the five types of recognized anxiety disorders.
- General Anxiety Disorder
Approximately six months of near constant state of worry, not related to a single event, results in a diagnosis of general anxiety disorder.
- Social Phobia/Anxiety
Irrational feelings making a person fearful of events, social settings, or objects, leading the person to avoid them.
- Panic Attack
Repeated and unprovoked feelings of panic or terror lasting ten minutes or less.
- Post-Traumatic Stress Disorder (PTSD)
Witnessing or being a part of a traumatic situation which causes repeated bouts of acute distress six months or more after the precipitating event. Symptoms may include involuntary intrusive memories, avoidance of potentially triggering situations, reactivity, disassociation, and other symptoms.
- Obsessive-Compulsive Disorder (OCD)
Repetitive thoughts and feelings forcing the person to repeat a task or behavior over and over again. To be disabling, this must cause severe distress and impede functioning in a work setting for a claim to be approved.
Social Security Disability Claim for Depression or Anxiety
Depression and anxiety can be difficult to prove because there is no laboratory test to establish these problems, so it becomes a subjective judgment. Experts must rely in part on a patient’s words to express their feelings; however there are a number of ways to make your claim more concrete.
The actual types of depression or anxiety do not concern SSA nearly as much as how those conditions are impacting your ability to work.
The First Step
The first step in your claim review is a determination of whether your are working at a substantial gainful activity (SGA) level In 2017, substantial gainful activity is defined by SSA as the ability to earn at least $1,170 gross wages per month or, if you are self-employed, the ability to earn $1,170 net profit and/or work eighty hours per month. If you are blind or legally blind, the threshold is $1,950. If you are performing SGA, your claim will receive a technical denial without a medical review. However, it is important to note that the dollar amount considered in the SGA evaluation is your earnings after they have been reduced by any Impairment-Related Work Expenses (IRWE’s), which include but are not limited to medical treatments and medication for your disabling conditions.
If work activity and earnings do not disqualify you, there are two methods for SSA to make a determination on the validity of your claim for benefits. One method uses the Blue Book, which lists various serious medical conditions and the symptoms or findings the conditions must cause to be listed. This provides a quick look for the disability examiner to assess whether you meet the requirements for depression or anxiety without considering your work history or transferrable skills to make the determination that you not work either in a past occupation or a new occupation.
To meet a listing for depression, you would need any four of the following impairments:
- Lack of energy
- Suppressed or enhanced appetite
- Lack of interest in general activities
- Difficulty in focusing on a task or in clear thinking
- Suicidal thoughts
- Lack in any physical activity
- Guilt or feelings with worthlessness, or
- Hallucinations, paranoia, or delusions
and extreme limitation of one or marked limitation in the ability to do two of the following
- Understand, remember, or apply information.
- Interact with others.
- Concentrate, persist, or maintain pace.
- Adapt or manage oneself.
The mental disorder has to be “serious and persistent;” that is, a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both:
- Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder and
- Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life .
Coupled with these, there must be a lack of social interaction, problems with focusing, extended and reoccurring periods with symptoms becoming worse, and problems with activities of daily living (ADL).
To meet the listings for anxiety, you would have to have three or more of the following:
- Easily fatigued;
- Difficulty concentrating;
- Muscle tension; or
- Sleep disturbance.
For a panic disorder or agoraphobia listing, you would have to have one or both of the following:
- Panic attacks followed by a persistent concern or worry about additional panic attacks or their consequences; or
- Disproportionate fear or anxiety about at least two different situations (for example, using public transportation, being in a crowd, being in a line, being outside of your home, being in open spaces).
For obsessive-compulsive disorder, you would need to have one or both of the following:
- Involuntary, time-consuming preoccupation with intrusive, unwanted thoughts; or
- Repetitive behaviors aimed at reducing anxiety.
And extreme limitation of one, or marked limitation of two, of the following areas of mental functioning:
- Understand, remember, or apply information.
- Interact with others.
- Concentrate, persist, or maintain pace.
- Adapt or manage oneself.
Or the mental disorder has to be serious and persistent; that is, you have a a medically documented history of the existence of the disorder over a period of at least two years, and there is evidence of both:
- Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder; and
- Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life.
If your condition does not meet the listings, your claim will be evaluated for possible approval as a Medical-Vocational Allowance. This means that both your vocational and educational background will be considered.
The claims examiner will review your file and obtain the relevant medical records that were listed when you filed your application. For a claim specifying depression or anxiety as a source, medical records from certified or licensed mental health professionals would be best. This could include records of examinations or treatments from psychiatrists, psychologists, mental health clinics, or hospitals. MSW counselors’ and mental health nurse practitioners’ records and opinions are not given as much weight as those of psychiatrists and psychologists. If you are getting your care only from a physician’s assistant or nurse practitioner or psychiatric social worker because those are the mental health professionals available in your geographic area, be sure to mention the reason on your application.
Make certain your doctor’s report has sufficient details as to how your symptoms affect your daily life and how effective the treatment plan turned out to be. If you were prescribed medication but chose not to take it, SSA may use this against approving your claim based on the assumption that your condition is not as severe as you claim or you would follow the treatment plan. However, if not being able to afford the medication or severe side effects are the reasons for not taking medications, those could be acceptable reasons. During the time your claim is reviewed, carry on with your regular consultations and treatment plan to continue building your medical file.
The Impact of Drug and Alcohol Use
Alcohol or drug problems can send your claim completely off course because Social Security and Supplemental Security Income benefits are not payable for disability caused by drug or alcohol use. This means that if your medical records indicate alcohol or drug abuse, dependency or addiction, you need to submit evidence that you are independently disabled due to a mental illness diagnosis irrespective of any alcohol or drug use. Otherwise, the disability examiner may reach a conclusion your disability is solely from, or materially contributed to by, that usage. For example, your depression might be determined to be a result of excessive substance abuse. A statement from your doctor could help by saying that you have a free-standing mental illness irrespective of the addiction. In addition, if you have a documented period when you were clean and sober but still suffered from depression or anxiety, it would strengthen your case.
Part of the investigation could be that the disability examiner would order a one-time consultation to be completed by a doctor SSA pays for and approves. The downside to this method is it may not produce a favorable result for you as far as approving your claim. The reason is that the doctor will only be seeing you one time and may not really be able to determine how your condition limits your work activity or the correct source of the limitations.
To avoid having your case rely only upon a consultative exam, your best chance of winning a claim approval is with thorough documentation of examinations, consultations, medications, and a complete medical history of your condition. Couple those with all your work records showing how your work activity has been affected.
Residual Functional Capacity (RFC) Evaluation
For the SSA to approve a claim for depression or anxiety when you do not have a condition that meets the listings, your limitations and your work history and education must show that you cannot perform SGA in any occupation you’ve worked in the past and in any new occupation. To do this, the claims examiner considers the skills you have from prior work, your education, and your age as well as your mental health residual functional capacity and compares those elements to the mental requirements of potential occupations. Your physician or a consulting physician may be asked to complete a mental status RFC questionnaire, which evaluates your ability to work with people, concentrate, follow instructions, submit to authority, and other mental and emotional capacities needed to work. Alternatively, the examiner may extract this information from existing medical records. Your residual capacities will then be compared to the mental and emotional demands of occupations that you could do if you did not have mental health limitations.
If You Are Denied
If your claim is denied, strongly consider getting a copy of your claim file and seeking advice from an attorney who specializes in depression and anxiety Social Security disability claims. That way you can get a professional opinion as to whether an appeal would be worthwhile.
If benefits are approved, a review called a continuing disability review (CDR) will be conducted in the future to determine whether you are still disabled at that time. Accordingly, it is important to remain under the ongoing care of a mental health professional.